Fluid from the ear

What is fluid from the ear?

Fluid or discharge from the ear, also called otorrhoea, refers to any substance draining from your ear. Sometimes it is your body getting rid of ear wax — a mixture of oil and solid materials your ears naturally produce to prevent dust and bacteria from getting in. However, sometimes it can be a sign of an ear problem or injury.

What symptoms are related to fluid from the ear?

Symptoms depend on what is causing the fluid or discharge. You might have pain, itching, loss of hearing or ringing in your ear, or you might feel unwell with dizziness or a fever. The fluid might contain wax, blood or pus.

What causes fluid from the ear?

Fluid draining from the ear is often caused by ear infections.

A middle ear infection, also called otitis media, causes a build-up of fluid behind the ear drum. It is especially common in children but can happen at any age. Sometimes the fluid causes so much pressure that the ear drum bursts. You might see thick yellow fluid draining from the ear following severe pain.

If the ear drum doesn’t heal, fluid can continue to drain out. This is called chronic suppurative otitis media. This can occur after a middle ear infection and can also occur if you have grommets. You might see lots of white, yellow or green fluid draining from the ear without any pain.

An outer ear infection, also called otitis externa or swimmer’s ear, occurs when the skin inside the ear canal swells and becomes infected. Discharge can build up in the ear canal and drain from the ear.

There are also serious infections that can cause fluid from the ear, such as mastoiditis (an infection of the bone behind your ear) or malignant otitis externa (an infection of the ear canal and part of the skull).

Other causes of fluid from the ear include the following:

• Damage to the ear drum — your ear drum can tear if you push an object such as a cotton bud in too deeply, or if you are exposed to changes in pressure. This can cause fluid to leak through the hole and out of your ear.
• An object in the ear — this usually happens if a child puts something like a small toy or stone in their ear. You might notice fluid containing blood or pus leaking from the ear.
• Cholesteatoma — this is an abnormal growth of cells in the middle ear, which can cause fluid with a bad smell to leak from the ear.
• A serious head injury — this can cause fluid from the brain to leak out of the ear. The fluid might look clear or blood-stained.
• Eczema of the ear — this can cause clear discharge.

When should I see my doctor?

See your doctor if you notice any fluid leaking from your ear. Keep your ear dry in the meantime, and avoid swimming or bathing until after you’ve been examined by a doctor.

You should also see your doctor immediately if your ear is swollen, painful or red or if you:

• have a fever
• feel dizzy or have trouble with your vision
• can’t hear properly
• have had an injury
• have diabetes or a weak immune system

How is fluid from the ear diagnosed?

Your doctor will look in your ear using an instrument called an otoscope. This is often all that’s needed to diagnose what is causing the fluid. Sometimes you might need to have a hearing test a CT or MRI scan.

How is fluid from the ear treated?

Treatment for fluid from the ear will depend on what is causing the problem.

Often you will be advised to keep the ear as dry as possible and avoid swimming.

Middle ear infections usually clear up in a few days without treatment. Occasionally you may need antibiotics. You can use pain relief such as paracetamol or ibuprofen.

Chronic suppurative otitis media and swimmer’s ear need to be treated with antibiotic ear drops.

Injuries to the ear drum usually heal without being treated. Sometimes you might need to take antibiotics if your doctor thinks there is a risk of infection due to the injury.

You may need to see an ear, nose and throat (ENT) surgeon, for example to remove a foreign body or to treat a cholesteatoma.

Can fluid from the ear be prevented?

Here are some things you can do to prevent conditions that can cause fluid from the ear:

• To prevent middle ear infections, practise good hygiene and make sure children are up to date with vaccinations.
• Don’t put anything in your ears and try to prevent children putting toys and food in their ears. You should not use cotton buds or any other objects to clean inside your ears.
• Avoid flying and diving if you have a blocked nose.
• To prevent swimmer’s ear, dry your ears after swimming or showering.

Complications of fluid from the ear

Whether you are at risk of complications depends on what is causing the fluid from your ear. If you are concerned, you should discuss this with your doctor.